Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Hansard source

I rise to speak on the Health Insurance Amendment (Pathology Requests) Bill 2010, which was previously considered by the House in the last parliament. It removes the legislative requirement for requests to be made to a particular approved pathology provider for Medicare benefits to be payable. But, as with a number of health bills, there were considerable concerns and this is another example of the ramshackle way in which the Minister for Health and Ageing deals with business in the House. I will come to another example later, but this is one example. Both non-controversial bills with which I am involved today deal with similar situations where the government has really failed in its consultation and not thought through the consequences of its actions. The concerns about this bill were first canvassed in the original debate and in evidence to the Senate inquiry. It was very good that the Senate did have an inquiry into this matter because it brought out quite a number of problems.

There is a variation in the range of services offered by pathology practices—in their methods, in the equipment used and in the methods of communication between pathology practices and referring doctors. Whilst cost is a very important consideration for patients, it may not always be the appropriate basis for deciding on a service provider. Indeed, that fact was even acknowledged by the minister in her second reading speech.

In this instance, the government basically failed to explain how new referral pathways will operate in cases where the pathology practice is unknown to the referring doctor. Of course, there were concerns about lost or delayed results and stakeholders flagged a whole series of concerns regarding lines of communication to the government and about the fact that these issues should have been resolved prior to implementation. Indeed, that was the subject of debate in the lower house. There is growing concern in the community about the decreasing levels of bulk-billing for pathology. Of course, that particularly affects older Australians, self-funded retirees and pensioners on fixed incomes. Another example of a failure by the government is in a disallowance motion where the government simply put things in the last budget because, having wasted so much money on things like putting in pink batts and building Julia Gillard memorial halls and all sorts of other things, they then had to go out and find money elsewhere. Typical of the government, given the attitude that the Prime Minister has towards older Australians, we saw measures and some cuts in the budget which directly affected older Australians, such as access to pathology. These things go into the budget without any consultation whatsoever. Then of course you have a problem and stakeholders come out and say: ‘Minister, have you thought about this and have you thought about that?’ No, of course she did not think about it, because all she was interested in was saving money. And this bill is another example of that.

So we had to go through this bill, and of course we have had a situation with a matter that is on the Notice Paper. Because the government has not organised its business properly, the disallowance motion which is before the Senate in relation to Health Insurance (Eligible Collection Centres) Approval Principles 2010 will not be dealt with. It will be dealt with when we come back in the new year. Notwithstanding that the government is having reviews into pathology matters and pathology funding which are going to be reflected in its next budget, instead of waiting for the outcome of those reviews here we are pushing through changes.

In this instance there were concerns with the original bill and there was scrutiny by the Senate through the committee process. The concerns here are about the onus that is being placed on patients to choose the pathology practitioner; problems which may arise between unknown referring doctors and pathology providers and which may result in delays; problems which may arise as a result of inconsistent reference ranges and measurement series used by different pathology providers; and possible effects upon arrangements between general medical practitioners and pathology providers relating to emergency and out-of-hours contact. The coalition senators in the minority report noted that of course we do support patient choice and that patient choice is very important, but this should not be at the expense of patient safety, the legal responsibilities of practitioners providing care and the practicalities of providing high-quality medical care. They recommended that the legislation be amended to allow referring doctors to specify a pathology provider in circumstances where there is a justifiable clinical need.

The coalition moved amendments in the lower house. It seems to happen with regular frequency in the Health and Ageing portfolio that the minister decides she is going to do something for some cost-saving measure, she does not think and then we have problems. When we start thinking about the patients we see where the problems are, and the government then has to backflip and change its position. This was another situation where that happened, and I am pleased that the government accepted the coalition’s amendments in the House to allow treating practitioners to specify a pathology provider where there is a clinical need to do so.

But, whilst we do not oppose the bill, we hold some concerns about the practical effects of its implementation and the lack of consultation that occurred prior to the initial introduction into the parliament. The coalition supports patient choice in accessing health care, but, as with any change of policy in this portfolio, proper consideration should be given to patient safety and quality of care. That is another 2009-10 budget measure not subject to consultation.

I have mentioned other instances. The classic one was the Better Access to Mental Health Care Initiative, which has certainly not been an area where this government has covered itself in glory. Indeed, it has covered itself in gross ingloriousness. Under the better access initiative, social workers’ and occupational therapists’ access under Medicare was often dropped. Often, particularly in rural and regional areas, social workers and occupational therapists are the only people that people have access to. But did the government think about patients in regional and rural areas? Of course they did not. Of course Minister Roxon did not think about that. She simply thought: ‘Okay, I’ll be able to save a bit more money here.’ It was not until we had an outcry by social workers and occupational therapists in the sector and we went through the spectacle at estimates where the minister and the department were put under scrutiny that Minister Roxon suddenly thought: ‘Oh, well, perhaps I might have another look at this’, and of course we saw another backflip.

The point that I am making is that this government looks at where it is going to save money but does not think about it. This is another such decision. Having said that, we have raised these concerns and we will continue to do so but on that basis we will not be opposing the bill, on the basis that the coalition’s amendments have been included.